Lawmakers call for end to reckless prescribing of psych meds to California foster kids

Some of the state’s most influential lawmakers on Monday called on California’s foster care system to stop the reckless prescribing of psychiatric medications to troubled children, demanding the state quit spending tens of millions of tax dollars on such risky therapies.

The demand for action comes just after this news organization published “Drugging our Kids,” an investigation that found nearly one in four adolescents in the nation’s largest child welfare system is prescribed at least one psych med — 3⁄2 times the rate of all teens.

Almost 60 percent of foster youth prescribed psychotropics in California are being given antipsychotics, the most dangerous and expensive class of the drugs, which can result in rapid-onset obesity, diabetes and uncontrollable tremors. Lawmakers expressed outrage by the news organization’s findings that many of the medications are prescribed for behavior management — not the mental illnesses they are approved to treat — and have little, if any, science supporting their safety and effectiveness in children.

“It’s easier to take care of a sleeping kid, but that doesn’t mean that it’s right,” State Sen. President pro Tem Darrell Steinberg said in an interview Monday. “And it certainly doesn’t mean that it’s in the best interest of the child — it’s obvious that in so many instances, it’s not.”

Steinberg said he was deeply concerned about the news organization’s finding that the state spends more on psychiatric drugs for foster children than on any other type of drug. An analysis of 10 years of Medi-Cal data showed psych meds accounted for 72 percent of spending on the 10 most expensive drug groups for foster children, topping $226 million.

Steinberg said that wide-open spigot, fueled by pharmaceutical company marketing, has to be restricted.

“What we know now is that $226 million, 72 percent of the total spent, is being used to over-prescribe and to over-rely on medication as the primary strategy to help these kids who have already had a tough life — and that the side effects and impact on their life and their growth are serious,” Steinberg said. “This report and these numbers tell me that this money is not being well spent in many instances.”

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Describing some of the sales pitches the news organization reported as “highly offensive,” Steinberg, whose term ends this fall, called on the governor and the state Legislature to “do some serious oversight and make the overprescribing of psychotropic medications to foster youth a lead budget issue in the 2015-16 state budget.

“By saying we are not going to allow this rate of spending to continue, it forces us policymakers and the folks who are responsible for implementing our Medi-Cal program and the child welfare system to better consider the use of medication and who would benefit from a different approach,” Steinberg said.

One senator on Monday said he was ready to lead the charge. Sen. Jim Beall, D-San Jose — who chairs the Senate Human Services Committee — said his committee will consider new policies and legislation to curb overprescribing when the new session begins in December. Beall said he intends to focus on what he calls “‘trash can diagnoses’ — diagnoses that are made simply to control behavior, as opposed to diagnoses that have a medically therapeutic value.”

Beall agreed with Steinberg’s urgency, noting: “There needs to be some action taken to reduce the inappropriate use of drugs in our foster care system — this is not a lightweight issue.”

Sen. Holly Mitchell, D-Los Angeles, agreed.

“Drugging kids to make them behave isn’t care, isn’t responsible and shouldn’t be legal,” she said in a statement. “Silencing their youthful pain by inducing stupor simply leaves childhood issues to fester into adulthood — and violates the obligation to ‘do no harm’ to those in our care.”

Members of the California Youth Connection, an influential advocacy group representing foster youth, said Monday they, too, are pleased to see the psych meds issue getting renewed attention, but they expressed frustration that their years of advocacy around expanded mental health rights have so far failed to move the state Legislature.

Youth advocates have long called for alternative therapies, informed consent on par with the rights of adult mental health patients, and better information from caregivers and prescribers about medications.

“In a family, you have a parent to advocate for a child,” said Vanessa Hernandez, the California Youth Connection’s statewide policy coordinator. “But foster youth don’t have that luxury and a lot of times they don’t have an ally to help advocate for what medications are appropriate. That’s what’s leading to this abuse, misuse and overuse.”